54-year old woman with a 4-cm solitary cystic in the body of pancreas. The lesion grew to 5.7 cm in 2 years although she remained asymptomatic. What was the most likely diganosis?
A. Pseudocyst.
B. Mucinous cystic neoplasm (MCN)
C. Pancreatic ductal adenocarcinoma.
D. Benign simple cyst.
E. Intraducatal mucinous papillary neoplasm (IPMN)

Answer: "B. Mucinous cystic neoplasm (MCN)."

A gallstone with golden-yellow crystal crush surface is most likely from
A. A 46-yo slightly overweight woman.
B. A 13-yo obesed boy with family history of heart disease and stroke.
C. An 80-yo man with long-standing pulmonary disease.
D. A 26-yo girl with sickle-cell anemia.
E. Both A and B. "

Multiple small black rock-hard gallstones are most likely from.
A 46-year old slightly overweight woman.
B. A 13-year old boy by the name of Don Giovani
C. An 80-year old man with long-standing pulmonary disease.
D. A 26-year girl with sickle-cell anemia.
E. Both B and D.

Answer: "Both B and E (hemolytic)"

52-yo woman with a history of Hashimoto thyroiditis developed signs of biliary obstruction. Malignancy was suspected. Imaging studies showed mild diffuse enlargement of pancreas and segmental dilation of main pancreatic duct. No discreet mass was detected. What additional tests would be valuable in diagnostic workup?

Which of the following about autoimmune pancreatitis is INCORRECT?
A. May occurs in a wide variety of organs and tissues.
B. Often forms an inflammatory fibroproliferative nodule or mass.
C. Presence of IgG4 positive plasma cells is diagnostic.
D. Elevated serum IgG4 level is common.
E. Swift response to steroid therapy.

Answer: C. These plasma cells can also be seen in a wide variety of inflammatory processes unrelated to autoimmunity.

A3-yo boy with growth delay was found to have a palpable abdominal mass confirmed by CT scan. A 13-cm solid mass was subsequently resected. The mass was lobulated with broad fibrous bands. A variety of different cell populations were seen microscopically. Which one additional histological component could be diagnostic for this tumor?

Answer:: False. High numbers of IgG4-positive plasma cells can also be seen in diverse non-specific inflammatory conditions.

62-yo woman with intermitantt abdominal discomfort for 2 years was found on CT scan to have a 6.5 cm (well circumscribed) noculated mass in the tail of the pancreas. What's the most likely pancreatic lesion?

Answer: Microcystic serous cystadenoma.

55-yo man was found to have a 2.8-cm nodule in the head of pancreas on imaging study; extrusion of mucoid material from Ampulla of Vater was noted endoscopically. He most likely had
A. Intraductal papillary mucinous neoplasm.
B. Mucinous cystadenoma.
C. Ductal adenocarcinoma.
D. Solid (cystic) pseudopapillary tumor.
E. Acinar cell carcinoma

Answer: "A.Pancreatic Intraductal papillary mucinous neoplasm."

61-yo man gradually developed skin rashes on the thigh and abdomenthat in the past two months. A vaguely palpable mass wass noted by PE. CT reveals a 6.8 multinodular in the body-tail of the pancreas. What did she most likely have?
A. Ductal adenocarcinoma.
B. Solid pseudopapillary tumor.
C. Acinar cell carcinoma.
D. Pancreatic mucinous cystic neoplasm.
E. Autoimmune pancreatitis